ACE2 (angiotensin-converting enzyme 2) is a membrane-bound enzyme primarily expressed in the lungs, heart, kidneys, and intestines. It plays a critical role in the renin-angiotensin system (RAS) by counterbalancing ACE activity, converting angiotensin II into angiotensin-(1-7) to regulate blood pressure and cardiovascular function. Notably, ACE2 serves as the functional receptor for SARS-CoV and SARS-CoV-2. enabling viral entry into host cells via spike protein interaction.
ACE2-targeting antibodies have gained prominence in biomedical research, particularly in COVID-19 therapeutics. Neutralizing antibodies against ACE2 can block viral attachment, potentially inhibiting infection. Additionally, ACE2 antibodies are used as research tools to study tissue distribution, enzymatic activity, and RAS-related pathologies like hypertension and diabetes. Some therapeutic strategies explore soluble ACE2 decoys or antibody-mediated ACE2 modulation to mitigate viral entry or organ damage.
However, ACE2 antibodies present dual implications. While inhibiting ACE2 may reduce viral infectivity, excessive blockade could disrupt its physiological protective roles in reducing inflammation, fibrosis, and oxidative stress. Current research focuses on developing antibodies that specifically neutralize viral binding without compromising ACE2's enzymatic functions. These antibodies also hold diagnostic value for quantifying ACE2 expression in diseases or evaluating COVID-19 susceptibility. Ongoing studies aim to optimize their therapeutic window for both antiviral and cardiometabolic applications.